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Ontology:
Thoracic Outlet Syndrome
(C0039984)

Definition (MSH)

A neurovascular syndrome associated with compression of the BRACHIAL PLEXUS; SUBCLAVIAN ARTERY; and SUBCLAVIAN VEIN at the superior thoracic outlet. This may result from a variety of anomalies such as a CERVICAL RIB, anomalous fascial bands, and abnormalities of the origin or insertion of the anterior or medial scalene muscles. Clinical features may include pain in the shoulder and neck region which radiates into the arm, PARESIS or PARALYSIS of brachial plexus innervated muscles, PARESTHESIA, loss of sensation, reduction of arterial pulses in the affected extremity, ISCHEMIA, and EDEMA. (Adams et al., Principles of Neurology, 6th ed, pp214-5).

Definition (MEDLINEPLUS)

Thoracic outlet syndrome (TOS) causes pain in the arm, shoulder, and neck. It happens when the nerves or blood vessels just below your neck are compressed, or squeezed. The compression can happen between the muscles of your neck and shoulder or between the first rib and collarbone. You may feel burning, tingling, and numbness along your arm, hand, and fingers. If a nerve is compressed, you may also feel weakness in your hand. If a vein is compressed, your hand might be sensitive to cold, or turn pale or bluish. Your arm might swell and tire easily.

TOS is more common in women. It usually starts between 20 and 50 years of age. Doctors do nerve and imaging studies to diagnose it.

There are many causes of TOS, including

Injury

Anatomical defects

Tumors that press on nerves

Poor posture that causes nerve compression

Pregnancy

Repetitive arm and shoulder movements and activity, such as from playing certain sports

Treatment depends on what caused your TOS. Medicines, physical therapy, and relaxation might help. Surgery may also be an option. Most people recover.

NIH: National Institute of Neurological Disorders and Stroke

Definition (NCI)

A syndrome resulting from the compression of the blood vessels or nerves in the space between the clavicle and first rib (thoracic outlet). It is caused by car accident injuries or repetitive job or sport-related injuries. Signs and symptoms include pain in the shoulders and neck, numbness in the fingers, and weakening grip.

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This page was written by Scott Moses, MD, last revised on 9/6/2012 and last published on 2/17/2018.